Apollo Hospital absolved from Allegations of Inflating Medical Bills

Mumbai: The District Consumer Disputes Redressal Commission (DCDRC), Mumbai Suburban Additional recently dismissed a complaint against Apollo Spectra Hospital in Chembur for allegedly charging an inflated bill for a minor foot surgery.

Ruling in favour of the hospital, the District Consumer Court concluded that the charges were justified and also pointed out that before the surgery, the complainant had been fully informed about the surgery expenses.

The history of the case goes back to 2018 when the patient approached the treating consultant general and laparoscopic surgeon at Apollo Spectra Hospital for examination for a small lump on the middle toe of left foot. Based on the treating doctor's advice, blood test, X-ray, ECG etc were conducted and consequently, the doctor advised for a minor operation.

As per the complaint, the doctor performed a 10-15 minute operation but later the patient was shocked to find that the final bill of the hospital was of Rs 1,01,500 for such a small/nominal operation. Additionally, deposit amount, medicines etc. were allegedly taken from the complainant for examination/tests from the hospital.

Protesting against this, the patient asked the hospital administration to charge an appropriate amount. However, the hospital administration allegedly told the complainant that the hospital had a package for each operation and patients were billed accordingly. When he objected to this, he was given a discount of Rs 15,225 and the final bill was calculated at Rs 86,275. 

Later, the patient filled a consumer complaint for cheating by charging exorbitant bills, providing defective service and following unfair business practice and requested the hospital to charge an appropriate amount and return the remaining amount, pay Rs 50,000 as compensation and Rs 10,000 as compensation for financial fraud committed by the hospital.

On the other hand, the hospital denied all the allegations and submitted that the complainant never objected to the diagnosis. As per the hospital, the complainant contacted the insurance company's representative available at the hospital voluntarily and submitted the forms and related documents to complete the Medi-claim process with Apollo Munich Health Insurance.

Thereafter, the operation was conducted on the left middle toe and after the post-operative examination, the complainant was discharged. The hospital billed Rs 1,01,500 to the complainant and later gave a discount of Rs 15,225 and thereafter the total amount was billed by the insurance company. The hospital claimed that the patient made false complaints regarding the increased bill for the treatment.

It was further submitted that even though the complainant received the best diagnosis and medical treatment, he voluntarily and knowingly consented to the treatment at the front desk, he brought up wrong allegations to get more discount on his total bill

While considering the matter, the consumer court noted that if none of the expenses incurred in the said mediclaim were eligible then the insurance company would definitely have denied it. However, that was not the case. 

Further, the Commission noted that the complainant gave his consent for the surgery on 08.11.2018 in a letter stating that "I take full responsibility of settling all the bills before leaving the Hospital". Also in the said consent letter, the complainant was asked to explain in a language that the complainant understood and it was clear that the complainant's signature was there. 

"It is clear that the complainant's hospital expenses were immediately paid by his insurance company. Therefore, the complainant cannot file a complaint in that regard now," opined the consumer court.

"Frontline hospitals are reputed hospitals and according to their prevailing standard of practice, how and how much they charge is decided. If the said cost is not affordable to the complainant then alternative hospital is available to him at that time. However, instead of going to any other hospital, the complainant underwent treatment / operation at the above hospital. Hence, it is clear from the above discussion that the appellant has not resorted to unfair business practice by charging exorbitant bills," it further noted.

Therefore, taking note of all these aspects, the Commission dismissed the consumer complaint against Apollo Spectra Hospital.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/apollo-257396.pdf

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